HomeMy WebLinkAbout1977-10-07 Permit, Water Meter #4972City Permit 4972
Contractor
Owner ^ C~^^iQ/^r C^c.r ^ T+ Rd.
State License No.City License No.
GENERAL PERMIT
CTIY Cff ORONO
Crystal Bay, Minnesota
473-7357
Pate to- 7' 77
Parcel No.
Section No.Lot Block Subdivision
Plat No.
Other Description:
I hereby agree that, in case a permit is granted, all work which shall be done and all materials which shall be used,
shall comply with the City Code of Orono applicable thereto and shall include all additional specifications as listed
below.
^J3 UJArreB. MemE/t-— ^ ^ ________________________________
Water Meter:Fee $
Sewer Hookup; (City)Fee $
Install Plumbing Systems:Fees
Install Sewage Disposal Systems:Fees
Install Water Hookup: (City)lI ’cc S
InAall Water Supply Systems: (Well)Fee S
SAC Fees
State Surtax:Fees
Total Amount Paid to City................
60.oo
/5-oa
Signature qf appli^int
■ Sn
Signature of City Offijjal a
/ /
Code: WMte-FUe Copy;Canary^Inspector's Copv; Pinkd inance Copy; Guld>ApplicaiU*s Receipt